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| 혈액투석환자에서 약물사용법 |
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| Abstract |
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Consideration of the interactions of drugs and dialysis must include an understanding of the mechanisms of transport during hemodialysis, I. E., diffusion, ultrafiltra- tion and membrane protein binding effects. Clearance is a function of molecular size, blood and dialysate flow, membrane area and permeability, and dialyzer support geometry. Protein binding and hematocrit decrease in the vivo clearance in comparison to those measured in vitro with aqueous solutions. The effect on the serum half-life is also determined by the distribution space and clearance by other routes. Other factors such as meta- bolic alterations of dialysis can affect pharmacologic activity, and the clinical response is the end product of many determinants. Hemodialy-is can effectively remove numerous drugs, which require supplemental dosage after dialysis. |
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